Hu Xiaolan, Wang Xiyu, Cai Chen, Guo Jiachen, Qian Xin, Yu Jiangyi, Huang Liji, Xie Shaofeng
Department of Endocrinology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China.
Department of Endocrinology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
Front Endocrinol (Lausanne). 2024 Dec 2;15:1514713. doi: 10.3389/fendo.2024.1514713. eCollection 2024.
To systemically assess the relationship between serum osteocalcin levels and the progression of diabetic kidney disease (DKD) in the Chinese population.
The PubMed, Web of Science, CNKI, Wanfang Database, VIP and Chinese Medical Journal full-text Database were searched. Two investigators independently reviewed the literature and extracted data based on predetermined inclusion and exclusion criteria. The Newcastle-Ottawa scale was used to assess the quality of the literature. The statistical analysis was performed using Stata16 software.
A total of 20 case-control studies encompassed 4 565 cases, consisting of 643 healthy controls (CN), 1 649 individuals with simple diabetes mellitus (DM), 1 305 with microalbuminuria (MI), and 968 with macroalbuminuria (MA). The meta-analysis results indicated that the serum osteocalcin levels in MI group were significantly lower than those in CN group and DM group [SMD = -1.15, 95% CI (-1.46, -0.85), P < 0.01; and SMD = -0.53, 95% CI (-0.69, -0.37), P < 0.01, respectively], and lower in the MA group compared to the CN group [SMD = -1.28, 95% CI (-1.79, -0.76), P < 0.01]. In the MA group, the serum osteocalcin levels were considerably lower compared to those in DM group and MI group [SMD = -0.93, 95% CI (-1.28, -0.58), P < 0.01; and SMD = -0.41, 95% CI (-0.65, -0.17), P < 0.01, respectively].
The serum osteocalcin levels are typically reduced and show a negative correlation with the severity of proteinuria in Chinese patients with DKD. This indicates a decline in bone formation at early-stage in DKD patients, which worsens as the disease progresses.
https://www.crd.york.ac.uk/PROSPERO/,identifier CRD42024580324.
系统评估中国人群中血清骨钙素水平与糖尿病肾病（DKD）进展之间的关系。
检索PubMed、Web of Science、中国知网、万方数据库、维普数据库和中华医学期刊全文数据库。两名研究者根据预先设定的纳入和排除标准独立审阅文献并提取数据。采用纽卡斯尔-渥太华量表评估文献质量。使用Stata16软件进行统计分析。
共有20项病例对照研究，涵盖4565例患者，包括643名健康对照（CN）、1649例单纯糖尿病（DM）患者、1305例微量白蛋白尿（MI）患者和968例大量白蛋白尿（MA）患者。荟萃分析结果表明，MI组血清骨钙素水平显著低于CN组和DM组[标准化均数差（SMD）=-1.15，95%置信区间（CI）（-1.46，-0.85），P<0.01；以及SMD=-0.53，95%CI（-0.69，-0.37），P<0.01]，MA组低于CN组[SMD=-1.28，95%CI（-1.79，-0.76），P<0.01]。在MA组中，血清骨钙素水平显著低于DM组和MI组[SMD=-0.93，95%CI（-1.28，-0.58），P<0.01；以及SMD=-0.41，95%CI（-0.65，-0.17），P<0.01]。
中国DKD患者血清骨钙素水平通常降低，且与蛋白尿严重程度呈负相关。这表明DKD患者早期骨形成下降，并随疾病进展而恶化。
